MyMedR

Fulltext The Effects of Pre-emptive Administration of Ketamine and norBNI on Pain Behavior, c-Fos, and Prodynorphin Protein Expression in the Rat Spinal Cord after Formalin-induced Pain Is Modulated by the DREAM Protein

Long I, Suppian R, Ismail Z

Korean J Pain, 2013 Jul;26(3):255-64.

PMID: 23861999 DOI: 10.3344/kjp.2013.26.3.255

We investigated the effects of pre-emptive administration of ketamine and norBNI on pain behavior and the expression of DREAM, c-Fos, and prodynorphin proteins on the ipsilateral side of the rat spinal cord at 2 and 4 hours after formalin injection.

Matched MeSH terms: Spinal Cord

Barriers to sexual activity: counselling spinal cord injured women in Malaysia

Julia PE, Othman AS

Spinal Cord, 2011 Jul;49(7):791-4.

PMID: 21321578 DOI: 10.1038/sc.2011.4

This study is a cross-sectional, face-to-face interview.

Matched MeSH terms: Spinal Cord Injuries/ethnology*; Spinal Cord Injuries/psychology; Spinal Cord Injuries/rehabilitation*

Fulltext COBB syndrome treated by staged intravascular embolisation and surgery

Sayuthi S, Moret J, Pany A, Sobri A, Shafie M, Abdullah J

Med J Malaysia, 2006 Jun;61(2):239-41.

PMID: 16898321 MyJurnal

A 28-year old Malay man with evidence of an upper motor neuron cord lesion was diagnosed to have a C7 to T2 spinal arterio-venous malformation and associated cutaneous vascular lesion. He finally agreed for treatment after 5 years of progressive spastic right lower limb weakness leading to inability to mobilize. A two staged intravascular procedure was done followed by surgery with recovery of ASIA impairment scale grade B.

Matched MeSH terms: Spinal Cord Neoplasms/complications; Spinal Cord Neoplasms/pathology; Spinal Cord Neoplasms/therapy*

Immunohistochemistry and spinal projections of the reticular formation in the northern leopard frog, Rana pipiens

Adli DS, Stuesse SL, Cruce WL

J. Comp. Neurol., 1999 Feb 15;404(3):387-407.

PMID: 9952355

Over 30 nuclei have been identified in the reticular formation of rats, but only a small number of distinct reticular nuclei have been recognized in frogs. We used immunohistochemistry, retrograde tracing, and cell morphology to identify nuclei within the brainstem of Rana pipiens. FluoroGold was injected into the spinal cord, and, in the same frogs, antibodies to enkephalin, substance P, somatostatin, and serotonin were localized in adjacent sections. We identified many previously unrecognized reticular nuclei. The rhombencephalic reticular formation contained reticularis (r.) dorsalis; r. ventralis, pars alpha and pars beta; r. magnocellularis; r. parvocellularis; r. gigantocellularis; r. paragigantocellularis lateralis and dorsalis; r. pontis caudalis, pars alpha and pars beta; nucleus visceralis secundarius; r. pontis oralis, pars medialis and pars lateralis; raphe obscurus; raphe pallidus; raphe magnus; and raphe pontis. The mesencephalic reticular formation contained locus coeruleus-subcoeruleus, r. cuneiformis, r. subcuneiformis, raphe dorsalis-raphe centralis superior, and raphe linearis. Thus, the reticular formation of frog, which is an anamniote, is organized complexly and is similar to the reticular formation in amniotes. Because many of these nuclei may be homologous to reticular nuclei in mammals, we used mammalian terminology for frog reticular nuclei.

Matched MeSH terms: Spinal Cord/anatomy & histology*; Spinal Cord/cytology; Spinal Cord/metabolism*

Fulltext Concomitant abducens and facial nerve palsies: A rare presentation in anti-aquaporin-4 antibody-positive neuromyelitis optica

Oo KT, Tay KS, Law WC, Shatriah I

Taiwan J Ophthalmol, 2019 12 05;10(3):235-238.

PMID: 33110759 DOI: 10.4103/tjo.tjo_69_19

Over the past decade, the discovery of disease-specific aquaporin-4 antibodies has led to a better understanding of the diverse spectrum of disorders that are associated with neuromyelitis optica. Brainstem manifestations have been increasingly recognized in this disease. However, multiple cranial nerve palsies as an initial presentation of neuromyelitis optica are uncommon. We report a rare case of anti-aquaporin-4 antibody-positive neuromyelitis optica that presented with unilateral abducens and facial nerve palsies. Notably, this case did not involve the optic nerve or the spinal cord. Diagnosing neuromyelitis optica that presents as an isolated acute brainstem syndrome is challenging, but the outcome may be devastating if the diagnosis is delayed.

Matched MeSH terms: Spinal Cord

Fulltext Delayed Post-operative Spinal Epidural Haematoma after Posterior Spinal Surgery: Report of Two Cases

Chung WH, Tan RL, Chiu CK, Kwan MK, Chan C

Malays Orthop J, 2020 Nov;14(3):170-173.

PMID: 33403080 DOI: 10.5704/MOJ.2011.027

Delayed post-operative spinal epidural haematoma (DPSEH) is diagnosed when the onset of symptoms is more than three days from the index surgery. DPSEH is a rare but serious complication of spinal surgery. Missed diagnosis will result in irreversible neurological deficit which may lead to permanent disabilities. We report two cases of DPSEH who presented with worsening neurological deficit four days after the index surgery. Magnetic resonance imaging (MRI) showed the presence of an epidural haematoma compressing the spinal cord. Surgical evacuation of haematoma were performed for both patients. Both patients experienced neurological improvement. Surgeons should have high index of suspicion to identify delayed onset of spinal epidural haematoma (SEH) and timely intervention should be taken to avoid irreversible neurological damage.

Matched MeSH terms: Spinal Cord

Rare morbidity of permanent quadriplegia caused by neurenteric cyst of the cervical cord

Tan Chor Lip H, Jih Huei T, Chong Abdullah A, Rahman NABA

Avicenna J Med, 2019 5 31;9(2):78-81.

PMID: 31143701 DOI: 10.4103/ajm.AJM_153_18

The incidence of neurenteric cyst (NC) is rare, accounting for 0.3%-1.3% of all spine tumors. The occurrence of quadriplegia caused by NC is even scarcer. Herein we report on a young girl with a rare NC over the C2-C5 spinal cord, which led to the morbidity of permanent quadriplegia despite early surgical intervention. This case highlights the rare morbidity of cervical cord NC presenting with permanent quadriplegia that failed to respond despite early surgical excision.

Matched MeSH terms: Spinal Cord Neoplasms

Fulltext Metastatic Thymic Carcinoma on Restaging 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography

Hoe Khoo AC, Ang SF

Indian J Nucl Med, 2020 10 21;35(4):364-366.

PMID: 33642772 DOI: 10.4103/ijnm.IJNM_123_20

Thymic carcinoma is a rare thymic epithelial cancer which is not only locally invasive but also highly aggressive disease. The prognosis for this cancer is poor and the surgery remains the mainstay of treatment. Thymic carcinomas have been shown to metastasize to the lymph nodes, lung, and liver. A 63-year old male who was successfully treated for thymic cancer in 2015, presented with metastatic disease recurrence to the spinal cord. We share interesting images of the spinal cord lesions as well as pituitary metastases that were incidentally detected on restaging 18F-fluorodeoxyglucose positron emission tomography-computed tomography.

Matched MeSH terms: Spinal Cord

A case of spinal meningioma

Monteiro ES

Journal of the Malaya Branch of the British Medical Association, 1940;3:410-4.

Matched MeSH terms: Spinal Cord Compression

Implication of HMGB1 signaling pathways in Amyotrophic lateral sclerosis (ALS): From molecular mechanisms to pre-clinical results

Paudel YN, Angelopoulou E, Piperi C, Othman I, Shaikh MF

Pharmacol Res, 2020 06;156:104792.

PMID: 32278047 DOI: 10.1016/j.phrs.2020.104792

Amyotrophic lateral sclerosis (ALS) is a devastating and rapidly progressing neurodegenerative disorder with no effective disease-modifying treatment up to date. The underlying molecular mechanisms of ALS are not yet completely understood. However, the critical role of the innate immune system and neuroinflammation in ALS pathogenesis has gained increased attention. High mobility group box 1 (HMGB1) is a typical damage-associated molecular pattern (DAMP) molecule, acting as a pro-inflammatory cytokine mainly through activation of its principal receptors, the receptor for advanced glycation end products (RAGE) and toll-like receptor 4 (TLR4) which are crucial components of the innate immune system. HMGB1 is an endogenous ligand for both RAGE and TLR4 that mediate its biological effects. Herein, on the ground of pre-clinical findings we unravel the underlying mechanisms behind the plausible contribution of HMGB1 and its receptors (RAGE and TLR4) in the ALS pathogenesis. Furthermore, we provide an account of the therapeutic outcomes associated with inhibition/blocking of HMGB1 receptor signalling in preventing motor neuron's death and delaying disease progression in ALS experimental models. There is strong evidence that HMGB1, RAGE and TLR4 signaling axes might present potential targets against ALS, opening a novel headway in ALS research that could plausibly bridge the current treatment gap.

Matched MeSH terms: Spinal Cord/immunology; Spinal Cord/metabolism*; Spinal Cord/pathology

Fulltext Intraspinal epidural hematoma in a warfarinized patient presenting with back pain: a case report

Jolina, W.N., Dazlin Masdiana, S., Afliza, A.B.

Medicine & Health, 2018;13(2):188-194.

MyJurnal

Warfarin is an anticoagulant that is commonly used as thrombo-prophylaxis in patients at risk of thrombo-embolic events. However, the use of warfarin is known to cause hemorrhage due to its anticoagulation effect. Although the common sites of hemorrhage are gastrointestinal and genitourinary tract, it can also occur in the least expected location. We report a rare case of spinal cord compression secondary to intraspinal epidural hematoma as a result of overwarfarinization in a patient who had undergone liver transplant. The patient underwent emergency decompression laminectomy of spinal cord and hematoma evacuation after the reversal of overwarfarinization to normal levels.

Matched MeSH terms: Spinal Cord Compression

Fulltext Steady state visual evoked potential based BCI as control method for exoskeleton: a review

Norhafizan Ahmad, Raja Ariffin Raja Ghazilla, Muhammad Zikril Hakim Md Azizi

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.

MyJurnal

Brain Computer Interfaces (BCI) provide a vast possibility in enabling the brain to communicate directly with the computer, hence providing an alternative in controlling the machines without much effort. In fields of rehabilitations robotics, the applications of an exoskeletons in assisting a spinal cord injured (SCI) patients were growing. Steady state visually evoked potentials (SSVEP) based BCIs that utilizes the human visual reactions to the constant flickered stimulus quickly showed its potentials among the BCIs used in rehabilitations devices because of its advantages such as a higher immunity to noises and artefacts and also its robustness compared to other BCIs. Rehabilitation exoskeletons demands an approach that are more user friendly and the aspects of control scheme and mechanical parts that are more focused on assisting the patients in rehabilitations and providing a SCI patients an alternatives to explore their surroundings in a more intuitive ways. This paper highlights the current development trends in SSVEP based BCIs for rehabilitation exoskeletons and proposed the potential research scopes in the future that can improve the effectiveness, and its potential applications in rehabilitations.

Matched MeSH terms: Spinal Cord

Fulltext Primary angiitis of the central nervous system with myelopathy as initial clinical presentation

Cheng, Yin Tan, Lingam, Ganeshwara, Suhailah Abdullah, Ai, Huey Tan, Tai, Sharon Mei-Ling, Norlisah Ramli, et al.

Neurology Asia, 2015;20(1):79-84.

MyJurnal

Primary angiitis of the central nervous system (PACNS) is a rare vasculitis restricted to the central nervous system without systemic involvement. Delay in diagnosis and treatment is common due to its non-specific symptoms and lack of non-invasive diagnostic tests. Myelopathy can occur in PACNS, during the clinical course of the illness, with or without cerebral symptoms. We describe here a 51 year-old ethnic Chinese woman who presented initially with paraparesis without cerebral symptoms. The diagnosis of PACNS was eventually made from brain biopsy when she subsequently developed cerebral involvement. Despite aggressive treatment, the patient developed progressive neurological deterioration and died. This patient demonstrates the rare occurrence of myelopathy as the sole initial presentation of PACNS.

Matched MeSH terms: Spinal Cord Diseases

Uncovering neural tube defects in humans through candidate gene expression patterns in mouse embryos

Nor Linda Abdullah, Mustakiza Muslimin, Hoo, Wan Mun, Fahimah Noor Ngah, Sheikh Mohd Norhafiz Abdul Aziz, Nor Syazwani Yip, et al.

Orient Neuron Nexus, 2010;1(1):2-6.

MyJurnal

Neural tube defects (NTDs) are the leading cause of disability in humans arising from the malformation of the central nervous system. The genes responsible and their involvement in causing neural tube defects in humans are poorly understood. Gene expression analysis in a whole organism enables the identification of the possible role of the gene being studied. If the gene is expressed in a particular tissue at a certain period of development, this spatiotemporal pattern of the gene of interest signals the possibility that the gene serves a function of being switched on in those tissues at that particular time. In this report, we have identified possible gene candidates in the mouse which may be required for the development of the neural tube, the precursor to the brain and the spinal cord. Development of the brain occurs by closure of the anterior neuropore (forms the cranial neural tube) while the spinal cord forms due to resolution of the posterior neuropore (forms the caudal neural tube). The genes Tiaml and T-cadherin were found to be likely candidate genes for the development of the spinal cord and may serve as potential human NTDs genes.

Matched MeSH terms: Spinal Cord

Fulltext Pulmonary rehabilitation using mechanical insufflation-exsufflation therapy for spinal cord injury – two case studies in the University Malaya Medical Centre

Tan, J.H., Aishah A. Fauzi, Hasnan, N.

JUMMEC, 2017;20(2):31-33.

MyJurnal

There is a high incidence of 36% to 83% of respiratory dysfunction in patients with acute cervical spinal cord
injury. Complications arising from respiratory dysfunction remain one of the most common causes of morbidity
and mortality in the spinal cord injured population. Specialized pulmonary care and therapy can help individuals
with tetraplegia to maintain a stable respiratory status allowing active participation in active rehabilitation.
This would allow them to achieve rehabilitation goals of independent function and community reintegration.
Mechanical insufflation-exsufflation (MIE) therapy is an option for secretion management in individuals with
acute spinal cord injury. In this paper, we present our experience using MIE as an adjunct to management of
secretions in the spinal cord injured population at the University of Malaya Medical Centre.

Matched MeSH terms: Spinal Cord Injuries

Analysis of reactive astrocytes and NG2 proteoglycan in ex vivo rat models of spinal cord injury

Patar A, Dockery P, Howard L, McMahon S

J Neurosci Methods, 2019 01 01;311:418-425.

PMID: 30267723 DOI: 10.1016/j.jneumeth.2018.09.027

BACKGROUND: The use of animals to model spinal cord injury (SCI) requires extensive post-operative care and can be expensive, which makes an alternative model extremely attractive. The use ofex vivo slice cultures is an alternative way to study the pathophysiological changes that can mimic in vivo conditions and support the 3Rs (replacement, reduction and refinement) of animal use in SCI research models.

NEW METHOD: In this study the presence of reactive astrocytes and NG2 proteoglycans was investigated in two ex vivo models of SCI; stab injury and transection injury. Stereological analysis to measure immunohistochemical staining was performed on the scar and injury zones to detect astrocytes and the chondroitin sulphate proteoglycan NG2.

RESULTS: The volume fraction (Vv) of reactive astrocytes and NG2 proteoglycans increased significantly between day 3 and day 10 post injury in both ex vivo models. This data shows how ex vivo SCI models are a useful research tool allowing reduction of research cost and time involved in carrying out animal studies, as well as reducing the numbers of animals used.

COMPARISON WITH EXISTING METHOD: This is the first evidence of an ex vivo stab injury model of SCI and also the first comparison of immunohistochemical staining for injury markers within stab injured and transection injured ex vivo slice cultures.

CONCLUSIONS: The use of organotypic slice culture models provide a simple way to study the cellular consequences following SCI and they can also be used as a platform for potential therapeutics regimes for the treatment of SCI.

Matched MeSH terms: Spinal Cord Injuries

Anterior spinal cord syndrome as a rare complication of acute bacterial meningitis in an adult

Ng KS, Abdul Halim S

BMJ Case Rep, 2018 Oct 24;2018.

PMID: 30361450 DOI: 10.1136/bcr-2018-226082

Acute bacterial meningitis is not an uncommon central nervous system infection. In severe cases, it can be associated with various neurological or systemic complications. However, acute spinal cord dysfunction rarely occurs. We report a case of bacterial meningitis complicated with spinal cord infarction despite adequate treatment with antibiotics and corticosteroid therapy. He had residual paraplegia and was fully dependent in the activity of daily living.

Matched MeSH terms: Spinal Cord/blood supply*; Spinal Cord Ischemia/microbiology*

Fulltext Partial duplication of tentorium cerebelli and complete duplication of falx cerebelli

Nayak SB, Shetty SD

Anat Cell Biol, 2019 Sep;52(3):337-339.

PMID: 31598364 DOI: 10.5115/acb.19.017

Variations of the dural folds and the dural venous sinuses are infrequently reported in the existing medical literature. Such variations in the posterior cranial fossa may pose difficulties in various analytical and surgical procedures of this region. We present a rare concurrent variation of the falx cerebelli and tentorium cerebelli that was detected during routine dissection of an adult male cadaver. While removing the brain, a partial duplication of tentorium cerebelli was observed below the left half of the tentorium cerebelli and above the left cerebellar hemisphere. This fold did not have any dural venous sinus in it. Further, a complete duplication of falx cerebelli with a single occipital venous sinus within its attached border was also observed. We present the review of literature and discuss the comparative anatomy of this case.

Matched MeSH terms: Spinal Cord

Fulltext Synovial juxtafacet cyst of the spine presenting as radiculopathy

Nizlan MN, Selvakumar K, Looi LM, Kunasegaran R

Malaysian Journal of Medicine and Health Sciences, 2005;1(2):131-134.

Juxtafacet cyst of the spine is a rare occurrence. Reports have described them as synovial cysts; ganglion cysts; extradural cysts as well as degenerative cysts of the spine. Patients may present with radicular pain, motor deficits, sensory disturbances, cauda equina syndrome and even myelopathy. Lumbar juxtafacet cysts may be confused clinically with prolapsed intervertebral discs or other conditions involving nerve root compression such as arachnoid cysts, ependymal cysts, dermoid cysts or teratomatous cysts. In the case of the juxtafacet cyst, surgical excision is usually curative. We report a case of spinal synovial juxtafacet cyst found intraoperatively in a case that was preoperatively diagnosed as prolapsed intervertebral disc. Synovial juxtafacet cyst of the spine should be considered as one of the differential diagnoses in patients, especially in older patients, presenting with nerve root compression.

Matched MeSH terms: Spinal Cord Diseases

Fulltext Spinal cord infarction in a young patient with methamphetamine abuse

Lee SY, Looi I, Mat Rabi M, Mohamed Micdhadhu MA

BMJ Case Rep, 2021 Mar 30;14(3).

PMID: 33785605 DOI: 10.1136/bcr-2020-241031

We report a case of a 20-year-old man who was diagnosed with spontaneous spinal cord infarction after abusing methamphetamine for a year. He presented with sudden onset of bilateral upper and lower limb weakness. His MRI spine showed a long segment of high signal intensity seen predominantly in the anterior spinal cord from medulla to mid thoracic level as well as a pencil-like hyperintensity seen postcontrast suggestive of spinal cord ischaemia or infarct. Thus, he was empirically treated for presumed anterior spinal cord infarction. He then developed autonomic dysfunction and went into respiratory distress, which required invasive mechanical ventilation support. Subsequently, he developed cardiac arrythmia with supraventricular tachycardiac followed by asystole and succumbed to illness on day 9 despite maximal resuscitative efforts. This case report illustrates a rare spinal cord infarction caused by methamphetamine intoxication and the importance of identifying and treating it early.

Matched MeSH terms: Spinal Cord

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